小儿缘何□下陷，泻久脾亏虚弱见，面目青黄四肢凉，六脉沈缓神惨淡，
补中益气汤最宜，固真汤进有奇验，外用乌附膏摊贴，温中理脾功无限。
[注]
小儿藏府有热 渴饮水浆，致成泻痢，久则脾气虚寒，不能上充脑髓，
故□陷成坑，名日□陷。
现证面目青黄,四肢逆冷，六脉沈缓，神气惨淡，
先以补中益气汤升提其气，再以回真汤温补其脾，
外用乌附摊贴于陷处极效。
(补中益气汤)方见飧泻
(固真汤)方见慢脾风
(乌附膏) 雄黄二钱 川乌 附子各五钱生 以上为细末 用生葱和根叶细切，
杵烂入前药末，同煎作成膏，每早空心贴陷处。
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杂证门
□门肿起气上冲，其间虚实要分明，毛发憔悴频频汗，胸高气促口唇红，
肝盛泻青丸最效，裹热连翘饮堪行，因表防风升麻剂，□冷属阴用理中。
[注]
□填者，谓□门肿起也，
盖因乳哺无度，或寒或热，乘于脾经，致使藏府不调，
其气上冲，为之填肿胀突，
现证毛发憔悴，频频出汗，胸高气促，口唇色红，
须分虚实治之，
肝气盛者，泻青丸主之，里热盛者，大连翘饮主之，
因表者，防风升麻汤主之，坚□不热者，属阴，理中汤主之。
(泻青丸) 方见急惊风。
(大连翘饮) 柴胡 荆芥 连翘去心 木通 滑石水飞 栀子
蝉退去足翅 瞿麦 当归酒洗 赤芍药 黄芩 甘草生 防风 水煎服。
(方歌)
连翘饮治热上冲，柴胡荆芥翘木通，滑石栀子蝉瞿麦，归芍黄芩草防风。
(防风升麻汤)
麦冬去心 木通 甘草节 山栀 升麻 防风 引用淡竹叶水煎服。
(方歌)防风升麻汤，□填效非常，麦冬木通草，山栀升麻防。
(理中汤) 方见不乳。
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杂证门
Why does the fontanelle of infants sink? Prolonged diarrhea leads to Spleen deficiency and weakness, manifesting as a greenish-yellow complexion, cold limbs, deep and slow pulse in all six positions, and a desolate spirit. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is most suitable; Guzhen Tang (Solidify the True Decoction) administered internally yields miraculous results; externally applying Wufu Gao (Aconite and Realgar Paste) to the area offers boundless efficacy in warming the middle and regulating the Spleen.
[Annotation]
When the internal organs of children have heat, they become thirsty and drink fluids, leading to diarrhea and dysentery. Over time, the Spleen Qi becomes deficient and cold, failing to nourish the brain marrow, causing the fontanelle to sink into a pit, named "Fontanelle Depression" (Xian).
Current symptoms include a greenish-yellow complexion, cold limbs, deep and slow pulse, and a desolate spirit.
First, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise the Qi; then use Huizhen Tang (Restore the True Decoction, i.e., Guzhen Tang) to warm and tonify the Spleen.
Externally apply Wufu Gao (Aconite and Realgar Paste) to the depressed area for extreme efficacy.
(Buzhong Yiqi Tang) See section on Hunxie (Sporadic Diarrhea).
(Guzhen Tang) See section on Manpi Feng (Slow Spasm Wind).
(Wufu Gao) Xionghuang (Realgar) 2 qian, Chuanwu (Radix Aconiti Preparata) and Fuzi (Radix Aconiti Lateralis Preparata) 5 qian each (raw). Grind the above into fine powder. Finely chop fresh scallions including roots and leaves, pound them into a paste, mix with the aforementioned powder, decoct together to form a paste. Apply to the depressed area every morning on an empty stomach.
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Miscellaneous Diseases Section
The fontanelle of infants swells upward, with Qi rushing up; one must clearly distinguish between deficiency and excess. If hair is withered, sweating frequently occurs, the chest is high, breathing is rapid, and lips are red:
For Liver excess, Xieqing Wan (Drain the Green Pill) is most effective; for interior heat excess, Dalianqiao Yin (Great Forsythia Decoction) is applicable; for exterior causes, Fangfeng Shengma Ji (Saposhnikovia and Cimicifuga Formula) is used; for cold fontanelles belonging to Yin, Lizhong Tang (Regulate the Middle Decoction) is indicated.
[Annotation]
"Fontanelle Fullness" (Tian) refers to the swelling of the fontanelle.
This is generally caused by unregulated nursing, or invasion by cold or heat pathogens affecting the Spleen Meridian, resulting in disharmony of the Zang-Fu organs.
The Qi rushes upward, causing the fontanelle to swell and protrude.
Current symptoms include withered hair, frequent sweating, a high chest, rapid breathing, and red lips.
Treatment must differentiate between deficiency and excess.
For Liver Qi excess, Xieqing Wan (Drain the Green Pill) is the primary formula; for interior heat excess, Dalianqiao Yin (Great Forsythia Decoction) is the primary formula.
For cases due to exterior pathogens, Fangfeng Shengma Tang (Saposhnikovia and Cimicifuga Decoction) is the primary formula; for hard and non-hot fontanelles belonging to Yin, Lizhong Tang (Regulate the Middle Decoction) is the primary formula.
(Xieqing Wan) See section on Jijing Feng (Acute Spasm Wind).
(Dalianqiao Yin) Chaihu (Bupleuri Radix), Jingjie (Schizonepetae Spica), Lianqiao (Forsythiae Fructus, heart removed), Mutong (Akebiae Caulis), Huashi (Talcum, water-flown), Zhizi (Gardeniae Fructus), Chantui (Cicadae Periostracum, feet and wings removed), Qumai (Dianthi Herba), Danggui (Angelicae Sinensis Radix, wine-washed), Chi Shaoyao (Paeoniae Radix Rubra), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Fangfeng (Saposhnikoviae Radix). Decoct in water and take orally.
(Verse Song)
Lianqiao Yin treats heat rushing upward, Chaihu, Jingjie, Lianqiao, Mutong,
Huashi, Zhizi, Chantui, Qumai, Danggui, Shaoyao, Huangqin, Gancao, Fangfeng.
(Fangfeng Shengma Tang)
Maidong (Ophiopogonis Radix, heart removed), Mutong (Akebiae Caulis), Gancao Jie (Glycyrrhizae Radix et Rhizoma with nodes), Shanzhi (Gardeniae Fructus), Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix). Use Danzhuye (Phyllostachys Nigra Folium) as guide, decoct in water and take orally.
(Verse Song) Fangfeng Shengma Tang, extremely effective for Fontanelle Fullness, Maidong, Mutong, Gancao, Shanzhi, Shengma, Fangfeng.
(Lizhong Tang) See section on Bulu (Failure to Nurse).
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Miscellaneous Diseases Section